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Factors Associated With Poor Child Motor Vehicle Restraint on the USA-Mexico Border
Alexander Schrodt1, Tam Huynh, Tamara N Fitzgerald
1Paul L Foster School of Medicine, Texas Tech University, EI Paso (Drs Schrodt and Fitzgerald and Mr Huynh) and Duke University Medical Center, Durham, North Carolina (Dr Fitzgerald).
Insights
Motor vehicle collisions (MVCs) pose a significant risk to children. On the USA-Mexico border, most children are not properly restrained in car seats, increasing injury severity, especially for those from New Mexico and Mexico.
Area of Science:
- Pediatric Trauma
- Public Health
- Occupant Protection
Background:
- Motor vehicle collisions (MVCs) are a leading cause of death and injury in children globally, with disproportionately high rates in low- and middle-income countries.
- Child passenger safety remains a critical public health issue, particularly in border regions with unique demographic and socioeconomic factors.
- Understanding car seat usage patterns and restraint effectiveness is crucial for developing targeted interventions.
Purpose of the Study:
- To assess car seat usage and restraint practices among children (0-9 years) involved in MVCs on the USA-Mexico border.
- To identify geographic disparities and correlations between MVC locations, screening checkpoints, and child injury severity.
- To evaluate parental awareness of car seat crash history and the prevalence of using previously crashed car seats.
Main Methods:
- A retrospective review of pediatric trauma admissions (0-9 years) from MVCs at a Level I trauma center.
- Analysis of data from the SAFE KIDS database, focusing on car seat usage and checkpoint screening.
- Correlation analysis between MVC locations, screening sites, and child injury severity, stratified by geographic region.
Main Results:
- 250 MVC admissions and 9 fatalities were recorded between 2010-2015; 9% of MVCs occurred in Mexico and 49% in El Paso, TX.
- While most inspected children were correctly positioned, 80% were inappropriately restrained; younger children showed higher restraint rates (p < .05).
- Children from New Mexico and Mexico exhibited the lowest proper restraint rates and highest injury severity scores; parental awareness of car seat crash history was low (37%), with 3% using previously crashed seats.
Conclusions:
- Inadequate car seat restraint is a significant public health concern on the USA-Mexico border, contributing to higher injury severity.
- Interventions should focus on high-risk geographic areas where MVCs and at-risk populations are concentrated.
- Enhanced restraint education is critically needed, especially for populations in New Mexico and Mexico, to improve child passenger safety outcomes.
Abstract:
Motor vehicle collisions (MVCs) are a significant cause of pediatric morbidity, particularly in low- to middle-income countries. We describe car seat use in children on the USA-Mexico border. A retrospective review was conducted for children 0-9 years old, admitted to the region's only Level I trauma center. Simultaneously, data were obtained from the SAFE KIDS database, a program that encourages car seat use through city checkpoints. There were 250 MVC admissions and nine fatalities in children 0-9 years old from 2010 to 2015. Nine percent of MVCs occurred in Mexico and 49% in El Paso, TX. Comparing trauma admissions to SAFE KIDS, there was some correlation between the location of MVCs and screening checkpoints (r = .50). There was a weaker correlation between injured children's neighborhoods and screening locations (r = .32). Only 37% of parents knew the crash history of the car seat and 3% were using a car seat previously involved in an MVC. While 96% of inspected children were placed appropriately in the backseat, 80% of children were found to be inappropriately restrained. Younger children more likely to be restrained (p < .05). Children from New Mexico and Mexico had the lowest rates of proper restraint and the highest injury severity scores. Proper use of car seats is a public health concern on the USA-Mexico border, and children are not properly restrained. Screening may be improved by focusing where at-risk children live and where most accidents occur. Restraint education is needed, particularly in New Mexico and Mexico.
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